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颈动脉切除与重建:28例连续病例的临床经验

Carotid artery resection and reconstruction: clinical experience of 28 consecutive cases.

作者信息

Zheng J W, Zhong L P, Zhang Z Y, Zhang C P, Zhu H G, Sun J, Fan X D, Hu Y J, Ye W M, Li J, Suen J

机构信息

Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China.

出版信息

Int J Oral Maxillofac Surg. 2007 Jun;36(6):514-21. doi: 10.1016/j.ijom.2007.01.010. Epub 2007 Mar 6.

Abstract

The aim of this study was to analyse the experience at a single institution in carotid artery resection with or without reconstruction performed as part of an oncological procedure or emergency haemostasis. A total of 28 patients were included in this retrospective study; 17 underwent ligation or resection of the carotid artery, and 11 underwent reconstruction of the carotid artery. The perioperative complications and surgical outcomes were recorded and analysed. Of the 17 patients with ligation or resection of the carotid artery, 4 developed neurologic deficit within 2 weeks postoperatively. Three patients with malignant tumours died 1 month (1) and 4 months (2) postoperatively. Of the 11 patients undergoing carotid reconstruction, no major cerebral complications were noted after operation. Colour Doppler showed patent vascular graft 1 year postoperatively in nine patients. Due to the higher complication rates both in short and long term with ligation or resection of the carotid artery, resection and revascularization of the carotid artery is advocated for patients with carotid artery involvement when possible.

摘要

本研究的目的是分析在单一机构中,作为肿瘤手术或紧急止血一部分进行的颈动脉切除伴或不伴重建的经验。本回顾性研究共纳入28例患者;17例接受了颈动脉结扎或切除,11例接受了颈动脉重建。记录并分析围手术期并发症和手术结果。在17例接受颈动脉结扎或切除的患者中,4例在术后2周内出现神经功能缺损。3例患有恶性肿瘤的患者分别在术后1个月(1例)和4个月(2例)死亡。在11例接受颈动脉重建的患者中,术后未发现重大脑部并发症。彩色多普勒显示9例患者术后1年血管移植物通畅。由于颈动脉结扎或切除在短期和长期均有较高的并发症发生率,对于可能累及颈动脉的患者,提倡进行颈动脉切除和血管重建。

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